| NPI | 1104375039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.022656) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: OH PT017752) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2020-02-20 |